摘要
目的:探讨5型磷酸二酯酶(PDE5)抑制剂对特发性肺动脉高压(IPAH)患者预后的影响。方法:纳入2005-05至2009-08期间在我院本部肺血管病诊治中心住院并新诊断为IPAH的患者89例。根据患者是否接受PDE5抑制剂分为PDE5抑制剂组(52例)及对照组(37例)。通过回顾性查阅病历收集患者的基线资料,电话随访和(或)查阅患者门诊病历获取患者生存状态及治疗情况。结果:PDE5抑制剂组及对照组在年龄、性别、身高、体重、血压、心率、世界卫生组织(WHO)肺动脉高压功能分级、6分钟步行距离、血流动力学及接受基础治疗比例,差异均无统计学意义(P均>0.05)。对89例患者平均随访(20.12±14.69)月,随访期间26例患者死亡。PDE5抑制剂组1、2、3年生存率明显高于对照组,差异有统计学意义(P<0.05)。WHO肺动脉高压功能分级为Ⅲ/Ⅳ级的患者,PDE5抑制剂组1、2、3年生存率明显高于对照组,差异有统计学意义(P<0.05);WHO肺动脉高压功能分级为Ⅰ/Ⅱ级的患者,PDE5抑制剂组1、2、3年生存率较对照组有改善的趋势,但差异无统计学意义(P>0.05)。当未包括6分钟步行距离时,84例患者多因素COX分析结果显示:体重(风险比=0.944,P=0.047),混合静脉血氧饱和度(风险比=0.934,P=0.006),接受PDE5抑制剂治疗(风险比=0.314,P=0.006)三参数将有助于评估IPAH患者的预后。当纳入6分钟步行距离时(n=41),多因素COX分析显示年龄(风险比=0.860,P=0.004)、6分钟步行距离(风险比=0.984,P=0.001)及接受PDE5抑制剂治疗(风险比=0.072,P=0.001)三参数将有助于评估IPAH患者的预后。结论:PDE5抑制剂对改善IPAH患者的预后有益。
Objective： To study the effect of phosphodiesterase type 5 （PDE5） inhibitor on improving the prognosis and survival in patients with idiopathic pulmonary arterial hypertension（IPAH）. Methods：We retrospectively enrolled 89 patients with newly diagnosed IPAH in our hospital from 2005 to 2008 and divided them into two groups. Inhibitor group, n = 52, the patients received PDE5 inhibitor treatment, and Control group, n = 37, the patients received conventional therapy. We summarized the medical records of all patients at the baseline, and the follow-up results were obtained by telephone visit or reviewing the clinical data of each patient. Results：All patients were followed-up for （20. 12 ± 14. 69）months, 26 patients died during that period of time. The baseline characteristics were similar between two groups ,P 〉 0. 05 respectively. The survival rate in Inhibitor group was significantly higher than that in Control group （P 〈 0. 05 ）. Patients with WHO functional class Ⅲ/Ⅳ in Inhibitor group had improved survival rate compared to that in Control group（ P 〈 0. 05 ）, while such statistical difference was not observed in patients with WHO functional class Ⅰ/Ⅱ（P 〉 0. 05 ）. When 6-minute walking distances parameter was excluded, n = 84, the independent survival predictors were as body weight （ HR = 0. 944, P = 0. 047 ）, mixed venous oxygen saturation （ HR = 0. 934, P = 0. 006 ） and receiving PDE5 inhibitor （ HR = O. 314 ,P =0. 006） ;when 6-minute walking distances parameter was included ,n =41 ,the independent survival predictors were as age （ HR = 0. 860, P = 0. 004 ）, 6-minute walking distances （ HR = 0. 984, P = 0. 001 ） and receiving PDE5 inhibitor （ HR = 0. 072, P = 0. 001 ）. There were three parameters involved in predicting the prognosis and survival in patients with IPHA. Conclusion：Using PDE5 inhibitor was beneficial to the prognosis and survival in patients with IPAH in clinical practice.
出处
《中国循环杂志》
CSCD
北大核心
2011年第2期117-120,共4页
Chinese Circulation Journal
基金
国家"十一五"科技支撑计划"提高肺动脉高压诊治水平的研究"(2006BAI01A07)
首都医学发展基金"肺动脉高压规范化诊断与治疗研究"(2005-1018)
关键词
5型磷酸二酯酶抑制剂
特发性肺动脉高压
预后
Phosphodiesterase type 5 inhibitor
Idiopathic pulmonary arterial hypertension
Prognosis
